Healthcare Solutions

America needs a fresh approach to fix its healthcare system, because America pays too much for healthcare and gets so little in return, and no previous reform attempts have really worked.

There are no easy solutions to exorbitantly-priced American healthcare so I don’t propose any. I do propose solutions that actually get to the heart of the reasons American healthcare costs so much and delivers so little. My solutions aren’t about changing benefit packages or co-pays. Manipulating these aspects of insurance coverage has had a minimal impact on the overall cost or quality of healthcare over countless reform attempts in the past.  Healthcare cost inflation has continued unabated for decades.

My proposed solutions will exist in addition to the plethora of health insurance choices already available. If you like your current health plan, you should keep it. However, you should also have healthcare choices that don’t currently exist. I’m talking about more effective choices that address the root causes of expensive American healthcare.

My first premise is healthcare insurance costs are really wages the employee earns that are currently siphoned off into the great American healthcare black hole without the employee’s full permission. Think of the insurance premiums your employer pays on your behalf as money that was generated by your work, only in my proposed solutions you can decide how much goes to take-home pay and how much goes to healthcare. The next time you are at the annual meeting where you and your fellow employees gather to learn about next year’s health insurance options, look to your right and look to your left. You and your fellow employees are the ones paying for healthcare, not the distant insurance company.

My second premise is the key to achieving significantly lower healthcare costs is the doctor-patient relationship must change. The current relationship, that all healthcare services are provided no matter how rare the benefit or expensive the service, is the root cause that explains why American healthcare costs so much. No other country has this doctor-patient relationship. In all other countries there is a balance between the needs of the individual patient and all the other patients. Therefore, new healthcare options must be created in America that foster a different doctor-patient relationship resulting in better bang for the healthcare buck.

When one of your fellow employees gets cancer and a doctor wants to order $200,000 of experimental unproven treatments, ask yourself, “Is it fair for the rest of us to pay for that?” There is no right or wrong answer to this question. The $200,000 has to come from somewhere, and it turns out that somewhere is your paycheck.

Some employees will believe such a transfer of money is appropriate, others won’t. The employees who don’t think this kind of expenditure for an experimental treatment is worth it should be allowed to gather themselves into an insurance pool separate from the people who feel this expenditure is appropriate. You should have this choice. You could put more of the fruits of your labor into an inefficient and expensive healthcare system, or you could take it home to your family.

The elderly of this country should have the same choice. Why let the federal government have all the say in how your benefits are divided?  The federal government sets aside a certain amount of money each year for its elderly citizens. This money is mostly spent on Social Security, Medicare, and Medicaid (which spends a lot of money on nursing homes). The elderly citizens of this country should have the same right to decide how much of their share of the pie should be spent on healthcare and how much should be spent on other living expenses.

Reasonable people will have different preferences of where to draw the line. Some will choose to continue with classic American healthcare benefits, others will want a small change, and others will want a significant change in their doctor-patient relationship so they can take home as much money as possible for living expenses.

My third premise is that health comes from more sources than the formal healthcare system. I believe many American’s overall health and well being would improve more if they had the freedom to move to a better neighborhood, buy a safer and more reliable car, and not have the stress of living paycheck to paycheck.

The Government Industrial Medical Coalition (GIMeC) doesn’t recognize this. It assumes the only route to better health is through more “simple” blood tests, CAT scans, and rounds of chemotherapy. GIMeC doesn’t acknowledge that people who are tired and depressed often feel better more from finding a better job and a good friend to talk to than a battery of tests and a prescription.

My fourth premise is that America has achieved remarkable accomplishments because it respects the judgment of individual citizens and families to make choices that are best for them. A heavy-handed top down approach never works well in America. Creating more choices does work.

I propose two healthcare options that don’t currently exist. The first option, Family Medicine Care, will not be easily achieved simply because it will involve change in the culture of American medicine and its patients. Change is stressful and there is always an inefficient transition period at the beginning of a journey. However, Family Medicine Care shouldn’t be too painful ultimately, because it will actually deliver better health at a lower cost.

The next option, Basic Healthcare, will be more difficult to create. Besides involving even more change, it will allow for difficult healthcare expenditure trade-offs. Basic Healthcare will include changes that will be too painful for many Americans. My proposed changes aren’t meant for everybody. But for people who really want to maximize their take-home pay and seek better health through other means than the formal healthcare system, and who are willing to accept some risk and give up long-cherished beliefs, Basic Healthcare will provide significantly more affordable healthcare.